title: Local cytokine changes in complex regional pain syndrome type I (CRPS I) resolve after 6 months.
abstract: There is evidence that inflammatory processes are involved in at least the early phase of complex regional pain syndrome (CRPS). We compared a panel of pro- and antiinflammatory cytokines in skin blister fluids and serum from patients with CRPS and patients with upper-limb pain of other origin (non-CRPS) in the early stage (< 1 year) and after 6 months of pain treatment. Blister fluid was collected from the affected and contralateral nonaffected side. We used a multiplex-10 bead array cytokine assay and Luminex technology to measure protein concentrations of the cytokines interleukin-1 receptor antagonist (IL-1RA), IL-2, IL-6, IL-8, IL-10, IL-12p40, and tumor necrosis factor-alpha (TNF-α) and the chemokines eotaxin, monocyte chemotactic protein-1 (MCP-1), and macrophage inflammatory protein-1β (MIP-1β). We found bilaterally increased proinflammatory TNF-α and MIP-1β and decreased antiinflammatory IL-1RA protein levels in CRPS patients compared to non-CRPS patients. Neither group showed side differences. After 6 months under analgesic treatment, protein levels of all measured cytokines in CRPS patients, except for IL-6, significantly changed bilaterally to the level of non-CRPS patients. These changes were not related to treatment outcome. In serum, only IL-8, TNF-α, eotaxin, MCP-1, and MIP-1β were detectable without intergroup differences. Blister fluid of CRPS patients showed a bilateral proinflammatory cytokine profile. This profile seems to be relevant only at the early stage of CRPS. Almost all measured cytokine levels were comparable to those of non-CRPS patients after 6 months of analgesic treatment and were not related to treatment outcome.
authors.affiliation: Department of Neurology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bochum, Germany Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany Department of Pain Medicine, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bochum, Germany Department of General, Visceral, Vascular, and Pediatric Surgery, Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Lenz
authors.forename: Nurcan
authors.initials: N
authors.lastname: Üçeyler
authors.forename: Jule
authors.initials: J
authors.lastname: Frettlöh
authors.forename: Oliver
authors.initials: O
authors.lastname: Höffken
authors.forename: Elena K
authors.initials: EK
authors.lastname: Krumova
authors.forename: Silke
authors.initials: S
authors.lastname: Lissek
authors.forename: Annika
authors.initials: A
authors.lastname: Reinersmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Sommer
authors.forename: Philipp
authors.initials: P
authors.lastname: Stude
authors.forename: Ana M
authors.initials: AM
authors.lastname: Waaga-Gasser
authors.forename: Martin
authors.initials: M
authors.lastname: Tegenthoff
authors.forename: Christoph
authors.initials: C
authors.lastname: Maier
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods* / Q000639:trends*; D011446:Prospective Studies; D012019:Reflex Sympathetic Dystrophy / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: Complex regional pain syndrome; Cytokine concentrations; Local inflammation; Neuropathic pain; Rehabilitation